Hong Kong East Cluster

1. Non-duplicate isolates from blood, urine and respiratory specimens. Interpreted according to CLSI. Nonsusceptible include both intermediate and resistant.
2. Overall prevalence of extended-spectrum beta-lactamases (ESBL) were 26% for E. coli, 15% for Klebsiella species,
   NB: For severe infection caused by ESBL-producing organisms, ertapenem, imipenem and meropenem are drug of choice for treatment
3. Nitrofurantoin: Susceptibility rate in urine isolates only.
4. Non-duplicate isolates from respiratory specimens only.
5. Methicillin-resistant staphylococci are resistant to all available beta-lactam antibiotics in PYNEH drug formulary, except ceftaroline.
6. Gentamicin is used only in combination with other active agents that test susceptible for staphylococcal infection.
7. Test performed on non-urine isolates only.
8. Enterococcus species: In general, susceptibility to penicillin can be used to predict susceptibility to these antibiotics: ampicillin, amoxicillin (Amoxil), ampicillin-sulbactam (Unasyn), amoxicillin-clavulanate (Augmenitn),and piperacilin-tazobactam (Tazocin).
   
9. , indicate 10% or more reduction in nonsusceptible rate compared to 2021.
   
   , indicate 10% or more increase in nonsusceptible rate compared to 2021.

* At meningitis MIC breakpoints, 37% was penicillin-susceptible and 63% was penicillin-resistant. At non-meningitis MIC breakpoints, 64% was penicillin-susceptible, 26% was penicillin-intermediate and 10% was penicillin-resistant. In S. pneumoniae, resistance to azithromycin & clarithromycin can be predicted by testing erythromycin.

# The annual number of isolates is small. Data from 2021 to 2022 were combined in the calculation.